Fascialage: A Refined Technique of Dorsal Augmentation in Rhinoplasty

Introduction  The primary aim of this paper is to describe an original technique for dorsal augmentation in rhinoplasty. The use of a carved block of costal cartilage or layers of septal cartilage is a well-known technique for dorsal augmentation. However, this is accompanied by the risks of cartilage warping and a hard, unnatural feel to the dorsum. On the other hand, the use of diced cartilage wrapped in the fascia, which has been another popular technique in the last decade, often does not give the structural stability of a solid cartilage. "Fascialage," as innovated by the authors, is a combined construct that incorporates all the advantages of these techniques eliminates the disadvantages of the previous techniques. Materials and Methods  Our technique involves the creation of a construct with three components and three parts. Radix augmentation is done with the cranial part, which consists of mostly rolled-up fascia; augmentation of the mid-dorsum is done with the central part, which has a solid cartilage platform, an overlay of diced cartilage with both being wrapped in the fascia, while the lower dorsum and supra-tip area also have all the same three components but with less diced cartilage. We can plan and alter the composition and dimensions as required for the individual case. Results  As a result of this, we believe that "fascialage" has the advantages of the other two techniques and consistent long-term results. Conclusion  This technique was used in 55 rhinoplasties needing considerable dorsal augmentation in which a postoperative follow-up of 2 to 5 years revealed that this technique yields reliable and sustainable results.